Food Allergies and MS: Is There a Connection?

By Lisa M. Basile
Reviewed by Dana Cooper, M.D.
May 08, 2023

If you have multiple sclerosis (MS)—a disease that causes the immune system to attack the protective layer (myelin sheath) around the nerves in the brain and spinal cord—you probably want to avoid flare-ups or relapses, or reduce their severity in any way you can. This may mean taking your medication, staying active, embracing self-care, and eating a healthy diet.

And when it comes to eating well, you may wonder which foods are right for you and whether any food sensitivities or allergies play a role in disease activity and cause worsening symptoms or disease progression. Here’s what to know.

Food Allergies vs. Food Sensitivity

Although food allergies and sensitivities are often lumped together in conversation, they’re not the same.

When you have a food allergy, the food in question (say, shellfish or berries) affects your immune system, leading to symptoms like rashes or breathing problems. For severe food allergies, exposure to that food may also lead to life-threatening anaphylaxis, causing you to need medication (like an epinephrine injection) to counteract the immune reaction.

On the other hand, a food that you’re sensitive to (such as dairy for people with lactose intolerance) may cause digestive troubles like bloating or constipation, but it doesn’t cause an immune reaction.

If you experience discomfort with certain foods and are not sure whether it may be a food allergy or sensitivity, talk to your doctor.

What Does the Research Say?

According to Karima Benameur, M.D., a board-certified neurologist at Emory Healthcare, in Georgia, the research is currently too limited to say for sure whether food allergies or sensitivities contribute to multiple sclerosis. Some research suggests that there may be a correlation (not causation) between food allergies and MS disease activity. At the same time, other studies have found no association between food allergies or sensitivities and MS disease activity. Let’s take a look.

A 2020 International Journal of MS Care study suggests that a food allergy is not associated with an increase in MS severity. The researchers explained that T helper 2 cells, which kick in during allergic reactions, may provide a protective immune response—one that could actually be helpful for people with MS.

This evidence may contradict findings from an earlier study, published in the Journal of Neurology, Neurosurgery & Psychiatry in 2018, which suggests that there is an association between food allergies and MS disease activity. People with self-reported food allergies had 1.38 times the rate of flare-ups compared to those without a food allergy. The people with MS who had food allergies were also found to have twice the chance of showing gadolinium-enhanced lesions (inflammation that is made visible on an MRI by gadolinium, a magnetic metallic element used in an MRI contrast dye ).

Another review examined research on MS and gluten, which can cause both allergies and sensitivities. The results were mixed and inconclusive. One study cited that a gluten-free diet was beneficial in MS, whereas others found that foods with gluten may be protective against MS. More research is needed.

“There really is no solid data showing that food allergies cause disease severity,” Benameur says. “An allergy is an inflammatory reaction. The question is, Does that inflammation [from food] get into your brain? There is a solid gut-brain barrier, and it’s very hard to get into the brain.”

Couldn’t the inflammation caused by eating something that you’re allergic to cause MS disease activity? Not directly, according to Achillefs Ntranos, M.D., a board-certified neurologist and MS specialist in Beverly Hills, California. What’s known is this: “The inflammation seen in allergies involves a different immune pathway than the inflammation that is involved in MS lesions,” he says.

The Gut, Food Allergies, and MS

Another area that could use more research is whether an imbalance in certain gut bacteria—due to diet—could be involved in MS. This is where sensitivities or allergies may potentially play a role.

“Food sensitivity or allergies could affect the gut microbiome and exert an impact on MS indirectly,” Ntranos says. “This is just speculation, however, as evidence regarding this interplay is lacking.”

The bottom line, according to experts: If you think you have a food allergy or sensitivity, it's important to discuss that with your doctor and follow their advice for living with it, but it probably doesn't affect your MS.

MS and Diet: What’s Best?

While much is still unknown about any effect of food allergies and sensitivities on MS disease activity, there is some guidance about what you can eat to help feel your best with MS.

When it comes to nutrition, there isn’t one single proven diet for MS, according to the National Multiple Sclerosis Society. Generally, though, researchers believe that eating an anti-inflammatory diet may help improve fatigue levels and quality of life in people with MS.

Avoid the most inflammatory foods as much as possible. These include refined or processed food, like white breads, chips, and crackers; drinks and snacks with added sugars; processed meats and red meats; and foods high in trans fats, like shortening, fried foods, and baked goods.

Benameur recommends a type of anti-inflammatory diet called the Mediterranean diet for people with MS. “This can help with fatigue, disease relapse, and cognitive dysfunction,” she says. Foods in this diet include fruits, veggies, beans, nuts, seeds, high-quality fats, moderate amounts of fish, herbs and spices prioritized over salt, and low to moderate dairy intake.

In the end, researchers believe there may be a link between the gut and MS, but there are no conclusive studies indicating what type of food is best, or how allergies or intolerances may affect MS. Benameur suggests working with your doctor and turning to credible sources of information around managing MS and your diet, like a registered dietitian.

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